Wheat Ridge, Colorado
Healthcare Homes without Walls
Donald Bechtold, MD and Harriet Hall, PhD
L-R: Shannon Tyson Poletti, Angela Green, Olga Martinez, Arthur Schut, Donald Bechtold, Harriet Hall
Health Care Homes without Walls is a pilot project at Jefferson Center for Mental Health that will promote systems integration and increase access to integrated mental health, substance abuse, and primary care services. It builds on existing collaborations with MCPN, Arapahoe House, and Foothills Behavioral Health Partners to take our integrated care programming to the next level.
The target population is adults with serious mental illness who previously lacked a primary care provider and are at risk of substance abuse. With funding through ACT, Arapahoe House will provide a part-time clinical specialist to provide substance abuse treatment and case management in three of Jefferson Center for Mental Health's larger adult outpatient sites.
Using other funding sources, MCPN will embed a physician assistant and medical assistant in the same three sites. The Jefferson Center Health Care Coordinator functions as the liaison between the medical and substance abuse treatment teams and between the FQHC and MH systems.
December 2011 Update
Two of the three Healthcare Homes without Walls (HCHWOW) clinics — MCPN primary care clinics co-located and integrated within Jefferson Center for Mental Health outpatient offices — began operations in April 2011 on a limited basis while MCPN awaited federal approval of the new sites.
This approval was received October 6th and greatly expedited and enhanced the efficiency of the referral process from Jefferson Center to MCPN and the capacity of the clinics. On October 7th, the third HCHWOW clinic opened at Jefferson Center.
Through December 13th, 464 referrals have been received for the three clinics — open clients of Jefferson Center without a PCP being referred to establish primary healthcare through the HCHWOW.
Of these 464 referrals, 346 have been scheduled for initial appointments with the MCPN provider. Of these 346 appointments, 219 have been kept, 53 have been scheduled for future dates, 53 have been no-shows, and 21 have been cancellations. Most of the 219 initial appointments have had follow up appointments.
The most common medical issues being referred to the HCHWOW clinics include hypertension, high cholesterol, thyroid issues, diabetes, migraines and health maintenance (women's healthcare and general physical exams).
Much progress has also been made regarding implementing substance treatment services, the third arm (along with physical and mental healthcare) of the integrated mental health centerbased healthcare homes, which is supported through the ACT innovation.
The Arapahoe House clinical specialist was identified in November, is orienting and training — in the MCPN and Jefferson Center clinical and personnel systems and EMRs — in December, and will be joining the MCPN PA and MA and the Jefferson Center Healthcare coordinator in delivering 3-way, real-time, integrated healthcare in the three Jefferson Center HCHWOW clinics in January 2012.
Don Bechtold, MD